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The developers of the BIRMINGHAM HIP paid attention to details. They looked at what had been successful in the past. They looked deep into the design and structure of those devices. They kept what they felt were critical features and performed studies to analyze those features that were in question.
Two basic areas were found to be critical to the functioning and long-term performance of a metal-on-metal hip resurfacing. The first area was the design and metal phase of the bearing itself. For this, the surgeons had the advantage of being able to replicate the design and metal phase of metal-on-metal total hips that were used in the 60s and 70s. Those with low wear that were revised for other reasons were compared to those with unacceptable wear rates. Certain features were identified and form the basis of the BIRMINGHAM HIP design.
Regarding fixation, none of the previous resurfacing devices clearly identified what would work best. The difficulty is that there was failure because of bearing problems, surgical problems and patient selection problems. A pilot study was done to determine the best method of fixation. Further development based in discoveries in other areas of total joint replacement helped refine the design. Now, after a decade of use, the fixation and design of the BIRMINGHAM HIP is the gold standard of resurfacing design.
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